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通过视频会议对脊髓损伤患者家庭照顾者进行问题解决训练:一项随机对照试验。

Problem-solving training via videoconferencing for family caregivers of persons with spinal cord injuries: a randomized controlled trial.

作者信息

Elliott Timothy R, Brossart Daniel, Berry Jack W, Fine P R

机构信息

Department of Educational Psychology, 4225 TAMU, Texas A&M University, College Station, TX 77845, USA.

出版信息

Behav Res Ther. 2008 Nov;46(11):1220-9. doi: 10.1016/j.brat.2008.08.004. Epub 2008 Aug 26.

Abstract

OBJECTIVE

To examine the effectiveness of an individualized problem-solving intervention delivered in videoconferencing sessions with family caregivers of persons living with a spinal cord injury (SCI) and possible contagion effects on care recipients.

DESIGN

Family caregivers were randomly assigned to an education-only control group or an intervention group in which participants received problem-solving training (PST) in monthly videoconference session for a year.

PARTICIPANTS

Sixty-one caregivers (54 women, 7 men) and their care recipients (40 men, 21 women) consented to participate.

MAIN OUTCOME MEASURES

The Social Problem-Solving Inventory-Revised was administered to caregivers. Caregivers and care recipients completed the Inventory to Diagnose Depression, the SF-36 and the Satisfaction with Life scale at pre-treatment, 6 months and 12 months.

RESULTS

Twenty-eight caregivers discontinued the study and their follow-up data were unavailable at the final assessment. Older caregivers were more likely than younger caregivers to remain in the study. Intent-to-treat analyses projected a significant decrease in depression among caregivers receiving PST; efficacy analyses indicated this effect was pronounced at the 6th month assessment. ITT analyses and efficacy analyses revealed that care recipients of caregivers receiving PST reported gains in social functioning over time.

CONCLUSIONS

Community-based, telehealth interventions may benefit family caregivers and their care recipients, but the mechanisms of these effects are unclear. Attrition and sample issues should be considered in future studies with these populations.

摘要

目的

研究通过视频会议为脊髓损伤(SCI)患者的家庭照顾者提供个性化问题解决干预措施的有效性,以及对受照顾者可能产生的传染效应。

设计

家庭照顾者被随机分配到仅接受教育的对照组或干预组,干预组参与者在为期一年的每月视频会议中接受问题解决训练(PST)。

参与者

61名照顾者(54名女性,7名男性)及其受照顾者(40名男性,21名女性)同意参与。

主要观察指标

对照顾者施测修订版社会问题解决量表。照顾者和受照顾者在治疗前、6个月和12个月时完成抑郁诊断量表、SF-36健康调查量表和生活满意度量表。

结果

28名照顾者退出研究,最终评估时无法获得他们的随访数据。年长的照顾者比年轻的照顾者更有可能留在研究中。意向性分析预计接受PST的照顾者抑郁症状会显著减轻;疗效分析表明,这种效果在第6个月评估时最为明显。意向性分析和疗效分析显示,接受PST的照顾者的受照顾者随着时间的推移在社会功能方面有所改善。

结论

基于社区的远程医疗干预可能使家庭照顾者及其受照顾者受益,但这些效果的机制尚不清楚。在未来针对这些人群的研究中应考虑损耗和样本问题。

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